ZCQ-33505-10298
2 vaccinations
2 coded responses
23 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 060 / CT
- Registered
- 2020-12-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Dose 1 — Moderna
-
2020-12-31
Registered in v-safe
- 2020-12-31
-
2021-01-01
Survey response — days 1–6 daily, dose 1MedDRA: Respiratory tract infection — Feeling: Good · Site: Pain · Muscle or body achesFree text: CongestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-06
- 2021-01-13
- 2021-01-22
-
2021-01-27
Dose 2 — Moderna
- 2021-01-27
-
2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Nausea, Abdominal painAdult check-in
- 2021-01-29
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-10
- 2021-02-19
- 2021-02-24
- 2021-03-05
- 2021-03-10
- 2021-04-28
- 2021-07-28
-
2022-01-27
Survey response — 12 months, dose 2MedDRA: COVID-19, Cough, Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Covid- rash, cough, etcMedDRA releases: 2024-11 · check-in free text available
-
2022-01-27
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-02-01
-
2022-02-03
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-01-27 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-27 | Successful 2022-02-03 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Congestion
Release 11 — 12 months, dose 2
Symptoms: Covid- rash, cough, etc
Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".
MedDRA terms by release
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SRO | Respiratory tract infection | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release